A. I am always concerned when anyone arbitrarily says "breasts will hurt" without thoroughly looking into the situation. Since this does not sound like a simple situation, I think it is important for your wife to be seen by a Board Certified Lactation Consultant. She needs to have a complete history taken and a complete feed should be observed. Continuing to nurse while in pain will jeopardize the breastfeeding relationship -- no one wants to hurt all the time!
Even though there is no redness or fever, I don't think you can rule out mastitis. Mastitis usually occurs in one breast and in one particular area, but it can occur in both breasts. Improper breast drainage could be a cause, leading to inflammation and pain, but no fever.
Since both breasts are stinging and throbbing, several things could be impacting your situation:
- Poor positioning. This can lead to back strain and referred breast pain. Be careful not to lean over your baby while nursing. Sit back in a comfortable chair, feet on a low footstool (or even a couple of phone books), with knees raised a bit above hip level. Bring the baby to your breast, using pillows to support your arms if needed. When the baby comes off the breast, note the shape and color of the nipple. It should be pink and round, with no creases or crunching.
- Improper drainage. Proper breast drainage is important. Nurse frequently. Most newborns nurse at least 10 to 12 times each day. When nursing, it isn't necessary to press your thumb into your breast to create an airway for your baby. Pull his bottom in closer to you body instead. Also, remember to wear a supportive, but not tight bra (no underwire).
- Forceful let down. In the early months a very forceful milk ejection reflex can cause this type of pain. This is more commonly seen with a very abundant milk supply.
- Sudden refilling of breasts. A sudden refilling of the milk ducts may be painful in the early weeks as nursing is established. This usually resolves on its own.
- Nipple blanching (vasospasm). Nipples may turn white, during, and sometimes in between feeds and may feel hot, burning and uncomfortable. Warmth (compresses) and good breast support may help to provide some relief.
- Ductal yeast. Have you seen any other signs of thrush in you or your baby?
Working with a board certified lactation consultant in you area should help you to figure out just what is causing your wife's pain, so you can then go about correcting the problem.
Hoping your wife will soon be able to experience pain-free nursing.
